VON Pre-budget Submission to the Government of Ontario

Putting More into Home and Community Care
VON Pre-budget Submission to the Government of Ontario

February 11, 2020

As Canada’s longest serving home and community care charity, VON is proud to serve people in communities throughout Ontario.

While much work is already underway in the health sector as a whole, we believe that even more can be done to contribute to healthier populations and a healthier system moving forward, with greater focus on home and community care. This meaningful change can be achieved through shifts in spending, changes in roles, and targeted investments in people, programs and technology.

Refocusing and rebalancing health spending to expand and strengthen home and community care will go a long way toward keeping Ontarians healthy and home – where they want to be. Home and community-based programs reduce social isolation, help maintain seniors’ independence, and reduce caregiver burden and burnout. Further, they keep people out of hospitals and long-term care, and support successful transitions from hospital to home, considerably reducing the strain on those facilities.

At a time when our healthcare system faces ongoing pressures and people continue to wait for care, we advance the following considerations for Budget 2020 in support of Ontarians’ health:

1. Streamline access to home care

In the current home care model, a lengthy assessment is undertaken by LHIN care coordinators (mostly nurses) to determine a patient’s eligibility. An assessment is then completed by the contracted agency that provides service. This process removes valuable nurses from direct care delivery, separates initial care assessment from care delivery, creates duplication in assessment for patients/families and takes time to complete – often resulting in delays in patients receiving the care they need at home, prolonged hospital stays and lack of care continuity.

Combine the care coordination with direct care functions performed by the home care providers to reduce hand-offs and support care continuity – removing the “middle man” by shifting investment from administration to direct care. Access could be even further expedited by permitting doctors, nurses, and hospitals to determine who needs care. Direct referrals to home care providers would enable critical hospital resources to be freed up and get patients into their homes, sooner. Putting decision making closer to where care delivery occurs can reduce duplication, cost and delays in care. 

2. Invest in technology in home care

Home care is high-touch. It delivers system efficiencies while supporting independence – and, like other parts of the health system, it can benefit from innovation and technology investment. VON leverages technology in our eHomecare offerings which enable a single skilled clinician, registered nurse, or therapist to oversee multiple trained ‘care technicians’ who provide at-home care. This integrated network provides patient information and real-time communication across the VON care team, strengthening consistency and continuity in the management of care plans, ensuring that people receive quality care, when and how it is needed. It is through investment in innovative tools like this that we can further realize the potential of home care. 

3. Innovate and integrate community care

People-centred VON programs like Assisted Living and SMILE (Seniors Managing Independent Life Easily) put more care control in the hands of clients and their families – ensuring they play a lead role in the development and management of their care plans. These programs leverage locally-available, traditional and non-traditional supports, and are proven to keep people at risk of institutionalization in their own homes and communities for longer. Ensure that the full spectrum of home and community care is considered in rebalancing investment across the sector.

4. Support home and community care employees

Lastly, we are deeply inspired by our front-line employees and what they do for patients and communities across Ontario. As the Ontario Health Teams take shape, we look forward to exploring wage parity for nurses and personal support workers working in all parts of the health system. To achieve real and lasting system improvements, we need a robust home and community care sector supported by a strong front line.  

Reflecting on last year’s commitment to new funding and your government’s mandate of ending hallway medicine, VON encourages even greater consideration of and commitment to home and community care, to home care providers and to the people who so greatly depend on all of us.